Revisional Bariatric Surgery
Revisional bariatric surgery, a complex procedure often necessitated by altered anatomy and diverse patient histories, is best performed by experienced surgeons. Turkey, especially Istanbul, stands out as an ideal destination for this surgery, thanks to its skilled surgeons, state-of-the-art facilities, affordable prices, and lack of waiting lists. Additionally, patients considering revisional bariatric surgery should consult with a surgeon to assess their individual needs and determine the procedure's exact cost, which is considerably lower in Turkey compared to European countries.
Medical review by Dr. Murat Üstün
To talk about revisional bariatric surgery, we mus start from the beginning. Two decades ago, certain surgeons viewedbariatric surgery as akin to experimental procedures. Nonetheless, in the past 20 years, this surgical approach has gained widespread acceptance due to various factors, including professional, economic, and ethical considerations. The surge in its popularity can be attributed to the growing need for surgical interventions capable of addressing severe and debilitating obesity.
Theeffectiveness of bariatric surgery is well-documented, and attaining weight loss is quite feasible when the right surgical approach is selected. The true measure ofsuccess in bariatric surgery lies in maintaining weight loss over the long term. It is essential to conduct extended follow-up examinations after bariatric surgery, spanning more than five years, to validate the surgical success. Weight regain is a possibility with each of the three main procedures, namelyRoux-en-Y gastric bypass,sleeve gastrectomy, and gastric banding. Consequently, some patients who experience weight regain may opt for revisional bariatric surgeries. The type of revisional procedure varies depending on the original surgical method used.
Why Turkey is the Best Country to Have a Revisional Bariatric Surgery?
Revisional bariatric surgery generally only can be done by experienced surgeons. The advantage ofTurkish surgeonslies in the number of surgeries they are performing. This experience brings a few important advantages for the patients.
Complexity of Revisional Surgery
Revisional bariatric surgery is generally more complex than primary bariatric procedures due to altered anatomy and the potential presence of scar tissue from previous surgeries. Experienced surgeons are better equipped to navigate these challenges.
Varied Patient History
Patients undergoing revisional surgery often have diverse medical histories, complications, and specific needs. An experienced surgeon is better prepared to customize the procedure to address individual patient factors.
Risk Mitigation
Revisional surgery carries a higher risk of complications than primary surgery. Experienced surgeons are skilled at identifying potential risks, taking necessary precautions, and responding effectively to complications if they arise.
Minimizing Further Surgeries
Revisional surgery may be a patient’s last chance to achieve significant weight loss and resolve complications. A skilled surgeon can minimize the need for further surgeries by getting the procedure right the first time.
Other than the advantage of experienced surgeons Turkey also offers affordable prices, and state-of-the-art healthcare facilities equipped with the latest medical technology and equipment, Multilingual Medical Staff also keep in mind that there is no waiting list in Turkey for revisional bariatric surgery. Istanbul is chosen by foreigners because of the considerable high-quality number of health facilities that Istanbul has.
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Cost of Revisional Bariatric Surgery in Turkey
The cost of revisional bariatric surgery can vary significantly depending on several factors, including the type of revisional procedure being performed. The cost of the surgery depends too much on the patient’s needs therefore consulting the doctor beforehand before receiving a price is crucial. In Turkey, prices are almost one-third of European countries. Also, keep in mind that revisional surgeries cost slightly more than initial bariatric surgery.
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Who Should Have Revisional Bariatric Surgery
The decision to have revisional bariatric surgery is made on a case-by-case basis and depends on several factors. Here are some scenarios in whichrevisional bariatric surgery may be considered:
Revision of the Band or Conversion to Other Procedures.
Laparoscopic adjustable gastric banding (LAGB) is a successful approach that ensures significant weight reduction in severely obese individuals Nevertheless, there is a growing demand for reoperations due to either inadequate weight loss or complications arising from the banding process. When faced with complications related to the band, various surgical alternatives must be evaluated, including band removal, repositioning, or transitioning to an alternative surgical procedure.
A crucial aspect to take into account is the timing of revision. The transition from LAGBto alternative procedures can be executed either as a one-step or a two-step process, contingent upon the presence of specific complications.
Revision of Sleeve Gastrectomy
If a patient did not achieve sufficient weight lossor has experienced significant weight regain after the initial sleeve gastrectomy, a revision may be considered.
Revision to Roux-en-Y Gastric Bypass
One common revisional option is converting the sleeve gastrectomy into a Roux-en-Y gastric bypass (RYGB)This involves creating a small stomach pouch and rerouting the small intestine to reduce calorie absorption.
Resleeve Gastrectomy
In some cases, a second sleeve gastrectomy may be performed to further reduce the size of the stomach and enhance weight loss.
Roux-en-Y Gastric Bypass (RYGB) Revision
RYGB remains the second most commonly performed bariatric surgery globally, accounting for approximately 15-20% of all such procedures However, there are instances where RYGB may not yield the desired weight loss results or may result in weight regain over time. The reasons for weight regain can be attributed to factors such as increased food intake due to the stretching of the gastric pouch, dilation of the gastrojejunal anastomotic complex, enlargement of the gastric pouch, or the presence of a gastrogastric fistula. Nonetheless, it appears that changes in eating behavior, particularly hyperphagia (excessive eating), are the primary contributors to weight gain followingRYGB. In most cases, salvage banding is chosen for revisional surgery Salvage banding can be performed via laparoscopy, involving the placement of either an adjustable gastric band or a nonadjustable silicone ring (Minimizer Ring) at the level of the gastric pouch to restore the restrictive effect.
This article is not authored by a medical professional; however, it provides a concise overview of various medical procedures sourced from academic papers within the field of medicine. While it does not substitute for expert medical advice, it offers a valuable summary of the information found in scholarly literature, making it a useful resource for those seeking a general understanding of these medical procedures. It is essential to consult with qualified healthcare professionals for in-depth and personalized medical guidance.
References
- The SAGES Manual: A Practical Guide to Bariatric Surgery Author(s): Ninh T. Nguyen, Eric J. DeMaria, Sayeed Ikramuddin, Matthew M. Hutter Year: 2008
- Bariatric Surgery: Technical Variations and Complications Author(s): Mervyn Deitel (auth.), Michael Korenkov (eds.) Publisher: Springer-Verlag Berlin Heidelberg, Year: 2012
- Review of Obesity and Bariatric Surgery: Essential Notes and Multiple Choice Questions Author(s): Subhash Kini; Raghavendra Rao Publisher: Informa Healthcare, Year: 2012
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
